Lisa J Dulcet, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · South Bend, IN
NPI 1760613681 · NPPES record last updated Oct 24, 2016
Key facts
- NPI
- 1760613681
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 34006380A (IN)
- Practice address
- 150 W Angela Blvd
South Bend, IN 46617-1101 - Phone
- (574) 232-5065
- NPI assigned
- Jul 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240205003130 | MI | Practitioner - Clinical Social Worker | 0648613877 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34006380A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cass County Community Mental Health Services | Clinical | Current |
Accepting new patients |
| Intercare Community Health Network | Past | Accepting new patients |
Locations
960 M 60 E
Cassopolis, MI 49031
Phone (269) 445-2451
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | 34006380A | IN | Yes |
Addresses
Primary practice location
150 W Angela Blvd
South Bend, IN 46617-1101
Mailing address
150 W Angela Blvd
South Bend, IN 46617-1101
Phone (574) 232-5065
Other providers in South Bend, IN
- Stacey Duchac Siciliano
- Amanda Jane Duddleson
- Randell Scott Dudley
- Jennifer Marie Duell
- Tamara Dujardin
- Amanda R Duley
- Joyce Vestal Dunfee
- Dungarvin Indiana, LLC
- Courtney Dunlap
- Monica A. Dunlap
All providers in South Bend, IN · Clinical Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.